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This study examined the feasibility of non-invasive infrared thermography to monitor skin graft viability. Sixty-three patients with skin defects attending a single institution from May 2022 to August 2023 were included. Patients underwent full-thickness or split-thickness skin grafts based on clinical indication. Infrared thermal images were obtained on postoperative days 0, 2, 4, 6 and 8. The temperature difference between the skin graft and surrounding normal skin was assessed using image analysis software. All 33 patients with full-thickness skin grafts showed successful healing. Among the 30 patients with split-thickness skin grafts, 7 experienced failure. The groups with successful full-thickness and split-thickness skin grafts exhibited a gradual increase in graft temperature, peaking on postoperative day 6 and decreasing on postoperative day 8. Temporal temperature changes were significant in each patient group (p < 0.001), and the differences in temperature change patterns between the two groups with successful grafts and the group with graft failure were also significant (p < 0.001). On postoperative day 6, the temperature difference was highest in the full-thickness skin graft group (0.197 ± 0.335°C), followed by the successful split-thickness skin graft group (0.426 ± 0.428°C), and the split-thickness skin graft group with graft failure (−2.100 ± 0.361°C). In conclusion, infrared thermal imaging can provide a non-invasive real-time assessment of graft status and predict graft success or failure.
The increased peripheral arterial disease (PAD) incidence associated with aging and increased incidence of cardiovascular conditions underscores the significance of assessing lower limb perfusion. This study aims to report on the correlation and utility of two novel non-invasive instruments: transcutaneous oxygen pressure (TcPO2) and forward-looking infrared (FLIR) thermography. A total of 68 patients diagnosed with diabetic foot ulcer and PAD who underwent vascular studies at a single institution between March 2022 and March 2023 were included. Cases with revascularization indications were treated by a cardiologist. Following the procedure, ambient TcPO2 and FLIR thermography were recorded on postoperative days 1, 7, 14, 21 and 28. In impaired limbs, TcPO2 was 12.3 ± 2 mmHg and FLIR thermography was 28.7 ± 0.9°C. TcPO2 (p = 0.002), FLIR thermography (p = 0.015) and ankle–brachial index (p = 0.047) values significantly reduced with greater vascular obstruction severity. Revascularization (n = 39) significantly improved TcPO2 (12.5 ± 1.7 to 19.1 ± 2.2 mmHg, p = 0.011) and FLIR (28.8 ± 1.8 to 32.6 ± 1.6°C; p = 0.018), especially in severe impaired angiosomes. TcPO2 significantly increased immediately post-procedure, then gradually, whereas the FLIR thermography values plateaued from day 1 to 28 post-procedure. In conclusion, FLIR thermography is a viable non-invasive tool for evaluating lower limb perfusion based on angiosomes, comparable with TcPO2.
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